Parapoxvirus Infections in the Country of Georgia: A Case Series

Abstract

Infections caused by viruses of the parapoxvirus (PPV) genus, including orf and pseudocowpox viruses, are frequently seen in both humans and animals in many regions of the world. These infections are often misdiagnosed or neglected because of the lack of clinician awareness, inadequate diagnostic capacity, and their relatively mild disease presentation, which may result in affected individuals not seeking medical attention. Although PPV infections should be routinely considered in patients with cutaneous lesions, especially in those who have occupational exposure to farm animals, they are often excluded from the differential diagnosis because they are not perceived as serious, resulting in underestimation of the burden of disease. Since 2014, significant enhancements to Georgia's epidemiologic and laboratory capacity have made PPV surveillance and detection possible. In this study, we present information on 27 confirmed cases of PPV infection reported to Georgia's national surveillance system from January 2016 through January 2017.

Genomic features and evolution of the Parapoxvirus during the past two decades

“…PPV infections normally occur in animals and even in humans throughout the world [11,14,16,17,40,41]. However, comprehensive studies on PPVs are still lack.…”

“…PPVs have a global distribution, and the ruminant flocks will be disturbed while virus emerged in many continents [8][9][10]. This virus is known to infect mammals, such as goats, sheep, cattle, camels, reindeer and other ruminants [11,12]. Human will also be infected by PPVs, following direct exposing to skin lesions from infected mammals.…”

“…Regular public health controlling and reporting of human PPVs infections are in place in a lot of regions of the world, containing Europe, South America and South America [11,[13][14][15][16][17]. Until now, there are live PPVs vaccines which may control the disease, but it may not entirely prevent this disease [18].…”

Geographic distribution and genetic characterization of poxviruses from human infections in Georgia, 2009–2014

“…In the first twelve months of operation, 27 laboratory-confirmed human cases of PPXV infection were identified, 21 of which were originally misclassified as suspected anthrax [ 5 ]. Most PPXV cases (85%) reported contact with cattle, while the remaining 15% had contact with sheep.…”

“…These results may explain the etiology of undiagnosed clinical cases seen in patients presenting with skin lesions during the sampling period. Poxvirus-associated infections have now been added to the notifiable diseases list in Georgia and to the Electronic Integrated Disease Surveillance System (EIDSS), and reporting of each suspected case has been required since January 2016 [ 5 ]. To avoid the development of antimicrobial resistance through misdiagnosis and inappropriate treatment with antibiotics, PPXV infections needs to be recognized early with correct treatment ensured.…”